Cystoscopy enables both diagnosis and treatment of bladder and urethral conditions. At Liv Hospital, it offers precise, minimally invasive care with effective recovery outcomes.
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Treatment and Care: From Visualization to Intervention
At Liv Hospital, a Cystoscopy (Sistoskopi) is not merely a diagnostic tool; it is a versatile platform for minimally invasive surgical treatment. Many urological conditions that once required open abdominal surgery can now be managed entirely through the “working channels” of a cystoscope. This “See and Treat” approach is a hallmark of our Urology Department, where we aim to resolve a patient’s condition during the same session as their diagnostic evaluation, reducing the need for multiple anesthesias and hospital stays.
The “Care” aspect of cystoscopy at Liv Hospital involves a highly specialized team of urologists, anesthesiologists, and nursing staff who prioritize patient safety and comfort. Whether we are utilizing high-energy lasers to break down a stone or performing a complex resection of a bladder tumor, every movement is guided by high-definition optics.
TURBT (Transurethral Resection of Bladder Tumor)
This is the most important and standard surgical treatment for suspected or confirmed Bladder Cancer. It is both a diagnostic and therapeutic procedure performed through the natural urinary tract without external incisions.
The Procedure:
A specialized rigid cystoscope called a resectoscope is inserted into the bladder. Through this instrument, the urologist uses a fine electrical loop to carefully “shave off” or resect the tumor layer by layer from the bladder wall. At Liv Hospital, deep tissue sampling is routinely performed from the base of the tumor to ensure that the muscle layer is included. This is essential for accurate staging, determining how deeply the tumor has invaded, and guiding further treatment, such as surveillance, intravesical therapy, or additional surgery.
Cystolitholapaxy (Bladder Stone Removal)
Bladder stones are a painful condition that can lead to infection, obstruction, and recurrent urinary symptoms, often associated with Bladder Stones.
The Treatment:
A high-energy Holmium:YAG laser fiber is passed through the cystoscope into the bladder. The laser is used to fragment large stones into fine dust or small pieces, which are then irrigated and washed out of the bladder. This minimally invasive approach avoids open surgery, reduces recovery time, and allows immediate relief of symptoms such as pain and urinary obstruction.
Urethral Stricture Dilation and Urethrotomy
This procedure is performed when the urethra becomes narrowed due to scar formation, known as Urethral Stricture.
Care:
Using the cystoscope as a visual guide, the urologist performs a Direct Vision Internal Urethrotomy (DVIU), where a small blade or laser is used to precisely cut the scar tissue. This restores the normal diameter of the urethral channel and improves urine flow. In some cases, dilation with progressively larger instruments may be combined with this technique to maintain long-term patency.
Ureteral Stent Placement and Removal
This is commonly used in patients with kidney stones, tumors, or any condition causing urinary obstruction affecting the upper urinary tract.
The Intervention:
A thin, flexible double-J stent is inserted through the cystoscope and positioned between the kidney and bladder. This internal “drainage tube” ensures continuous urine flow even when the ureter is blocked. It prevents kidney damage, relieves pressure, and reduces pain. Stents may later be removed or exchanged depending on the underlying condition.
Botox Injections for Overactive Bladder
This treatment is used in patients with severe urgency and frequency due to Overactive Bladder who do not respond adequately to medication.
Treatment: A tiny needle is used to inject botulinum toxin (Botox) directly into different spots in the bladder muscle. This relaxes the overactive muscle fibers, increases bladder capacity, and significantly reduces urgency episodes and urinary incontinence. The effect typically lasts several months and can be repeated if necessary.
Cauterization of Bleeding Vessels
This technique is often required in patients with chronic bleeding conditions such as Radiation Cystitis or fragile bladder mucosa.
Care:
An electrocautery device is used to precisely “seal” or “spot-weld” bleeding blood vessels on the bladder lining. This immediate coagulation stops active bleeding (hematuria), stabilizes the bladder environment, and prevents recurrent blood loss. It is a highly controlled and targeted method that avoids the need for open surgery.
Removal of Foreign Bodies
Foreign bodies in the bladder may occur due to previous surgeries, chronic catheterization, or calcified medical devices.
The Tool:
Specialized graspers, baskets, or forceps are introduced through the cystoscope to safely capture and remove these objects. This may include retained sutures, broken catheter fragments, or encrusted stents. The procedure is performed entirely endoscopically, avoiding external incisions and minimizing recovery time.
Retrograde Pyelography and Intervention
This technique is used when abnormalities are suspected in the ureters or kidneys beyond the bladder.
Care:
During cystoscopy, fine catheters are inserted into the ureteral openings. Contrast dye is then injected to visualize the upper urinary tract under X-ray imaging. In addition to diagnosis, this approach can also facilitate therapeutic procedures such as ureteral stent placement or stone management, especially in complex cases involving obstruction.
Intravesical Therapy (BCG or Chemotherapy)
This is an important adjunct treatment following tumor resection in cases of non–muscle invasive Bladder Cancer.
Goal:
A catheter is used to instill liquid medications directly into the bladder, most commonly Bacillus Calmette–Guérin (BCG) or chemotherapeutic agents. This localized therapy targets microscopic cancer cells remaining after TURBT, significantly reducing recurrence risk and improving long-term outcomes while minimizing systemic side effects.
Management of Prostatic Obstruction
This procedure is used in men where an enlarged prostate obstructs urinary flow, commonly due to Benign Prostatic Hyperplasia.
Treatment:
Using laser technology through the cystoscope, the obstructing part of the prostate—often the median lobe acting like a “ball-valve”—is carefully trimmed or vaporized. This immediately relieves bladder outlet obstruction, improves urinary flow, and reduces symptoms such as hesitancy, weak stream, and incomplete emptying.
Surgical Excellence at Liv Hospital
Liv Hospital’s Operating Suites boast the world’s most advanced endoscopic and laser technologies. Our urological surgeons are pioneers in Minimally Invasive Endourology, focusing on techniques that maximize the eradication of disease while minimizing post-operative pain and recovery time. At Liv Hospital, we create a holistic care environment, tailoring every treatment to the patient’s specific anatomy and pathology. At Liv Hospital, we don’t just visualize the problem; we solve it with surgical mastery and compassionate care.
Send us all your questions or requests, and our expert team will assist you.
Not always. If a tumor is very large or if a patient has a severe active infection, we may perform a diagnostic check first and schedule the surgical treatment for a later date once the patient is stabilized.
If a tumor was removed (TURBT) or a large stone was broken, a catheter is usually left in the bladder for 24 to 48 hours at Liv Hospital to allow the area to heal and to wash out any blood or debris.
Yes. The Holmium laser is highly precise; it only penetrates a fraction of a millimeter into the tissue, making it extremely safe for use in the delicate environment of the bladder and ureter.
It is a stent with curls at both ends (one in the kidney, one in the bladder) to keep it in place. It is placed via cystoscopy and usually removed a few weeks later in a quick, 5-minute procedure.
Most procedures are “day surgeries,” meaning you go home the same day. For more extensive tumor resections, an overnight stay at Liv Hospital may be required for monitoring.
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